Ventricular Tachycardia with ST Elevation in Lead aVR Associated with Normal Coronary Arteries: A Case Report and Review of Literature

Pramod Theetha Kariyanna¹, Harshith Priyan Chandrakumar², Ruchi Yadav³, Amog Jayarangaiah⁴, Apoorva Jayaranagaiah⁵, Rafsan Ahmed², Debora Ponce² and Samy I. McFarlane^2,

¹Division of Interventional Cardiology, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel Hospitals, New York City, NY-10025, U.S.A.

²Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203, U.S.A.

³Department of Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, NY 11212, U.S.A.

⁴Trinity School of Medicine, 925 Woodstock Road, Roswell, GA 30075, U.S.A.

⁵Department of Internal Medicine, Albert Einstein College of medicine/ Jacobi Medical Center, Bronx, N.Y., U.S.A.

Cite this paper

Pramod Theetha Kariyanna, Harshith Priyan Chandrakumar, Ruchi Yadav, Amog Jayarangaiah, Apoorva Jayaranagaiah, Rafsan Ahmed, Debora Ponce and Samy I. McFarlane. Ventricular Tachycardia with ST Elevation in Lead aVR Associated with Normal Coronary Arteries: A Case Report and Review of Literature. American Journal of Medical Case Reports. 2021; 9(3):201-205. doi: 10.12691/AJMCR-9-3-17

Abstract

As per the 2013 guidelines of ACCF/AHA (American College of Cardiology Foundation/ American Heart Association), ST Elevation (STE) in lead augmented vector right (aVR), along with ST depression in multiple leads, is associated with critical stenosis of left main coronary artery (LMCA), left anterior descending artery (LAD) or a triple vessel disease (TVD). Early identification of ST-Elevation Myocardial Infarction (STEMI) is important as timely reperfusion with intervention can save myocardium and improve survival. We present a case of a 70 years old female, with cardiovascular risk factors, who presented to the emergency department with chest pain decompensating with ventricular tachycardia. On cardioversion, she was found to have ST elevation in aVR with ST depression in V4-V6, I, II, and aVL. However subsequent echocardiogram and coronary angiogram showed normal coronary arteries and left ventricular function.

Keywords

coronary angiography, Augmented vector right (aVR), Electrocardiogram (ECG) criteria, ST elevation myocardial infarction (STEMI), left anterior descending artery (LAD), left main coronary artery (LMCA)

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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